{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:49:44Z","timestamp":1782118184601,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rheumatic diseases are a major burden on individuals and health care systems. Shortages of health care providers, limited capacity at academic medical centers, and geographic and socioeconomic challenges contribute to this burden. The Extension for Community Healthcare Outcomes (ECHO) enables community\u2010based primary care providers (PCPs) to partner with academic medical center\u2013based specialists to deliver best practice care to underserved communities. This study evaluated the reach and impact of the ECHO Colorado Rheumatology program on PCPs who work in underserved areas in Colorado.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participation, self\u2010reported demographic, and self\u2010efficacy data of participants who attended the series between 2020 and 2023 were assessed. Changes in self\u2010efficacy before and after the series were analyzed using a Wilcoxon signed rank test. A retrospective secondary analysis assessed whether participation increased the proportion of participants rating their ability as \u201ccompetent or higher\u201d changed after participation in the series using McNemar's test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 211 providers participated in the program, and 93% resided in Colorado. Self\u2010efficacy ratings improved across all learning objectives, with a statistically significant improvement in 9 of 10. The proportion of participants reporting a level of \u201ccompetence or higher\u201d also significantly improved in 8 of 10 learning objectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most self\u2010efficacy scores in the learning objectives identified in this study improved after participation in the ECHO Colorado Rheumatology series, demonstrating improved PCP self\u2010reported competence in identifying, evaluating, and diagnosing rheumatologic conditions. Additionally, by reaching providers who work with medically underserved populations, ECHO Colorado hopes to improve patient access to rheumatologic care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80095","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:21:45Z","timestamp":1780316505000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Technology to Address Workforce Shortage: Impact of\n                    <scp>ECHO<\/scp>\n                    Rheumatology on Primary Care Providers"],"prefix":"10.1002","author":[{"given":"Elizabeth","family":"Hop","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Kollin","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Young","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duane","family":"Pearson","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Thomas","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Griffith","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23518"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X221137127"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/OARRR.S493457"},{"key":"e_1_2_7_5_1","volume-title":"The ECHO Model"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009370"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549071220S214"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23802"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23889"},{"key":"e_1_2_7_10_1","volume-title":"Guidelines for Writing Learning Objectives","year":"2013"},{"key":"e_1_2_7_11_1","volume-title":"Taxonomy of Educational Objectives, Handbook I: The Cognitive Doman","author":"Bloom BS","year":"1956"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15430421tip4104_2"},{"key":"e_1_2_7_13_1","volume-title":"Taxonomies of learning"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.20001"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001328"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.21291"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/28338073.2024.2420373"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1059840519861748"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.11.004"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2011.01270.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.100207"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2615-x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.5860\/ital.v42i4.16475"},{"key":"e_1_2_7_24_1","volume-title":"IBM SPSS Statistics for Windows","year":"2021"},{"issue":"1","key":"e_1_2_7_25_1","first-page":"47","article-title":"Manipulating measurement scales in medical statistical analysis and data mining: a review of methodologies","volume":"19","author":"Marateb HR","year":"2014","journal-title":"J Res Med Sci"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.21.s1.4388"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.22.s1.7000"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.evalprogplan.2018.05.002"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid3104.240913"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549241283173"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2021.03.200563"},{"issue":"1","key":"e_1_2_7_32_1","first-page":"12","article-title":"Increasing share of practicing female family physicians, 2010\u20102020","volume":"103","author":"Wilkinson E","year":"2021","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/21501327211005303"}],"container-title":["Arthritis Care &amp; 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